Introduction

Disclaimer: This is the fourth report on vaccine preventable disease and vaccination coverage in Australia, and is produced by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases and the Australian Institute of Health and Welfare on behalf of the Australian Government Department of Health and Ageing
published as a supplement to the Communicable Diseases Intelligence journal Volume 31, June 2007.

Page last updated: 20 July 2007

This is the fourth national report on the morbidity and mortality from vaccine preventable diseases (VPDs) and vaccination coverage in Australia. The first (1993 to 1998) was published in 2000, the second (1999 to 2000) in 2002 and the third (2001 to 2002) in 2004.1–3 The progressive decline in the incidence of all the childhood VPDs continues, with the possible exceptions of pertussis and mumps where notifications have increased although this is not reflected in hospitalisations. Most striking has been the 99.75% decline in the numbers of deaths from these diseases since the prevaccination era, despite the Australian population increasing almost threefold (Table 2), and the close associations of declines in individual disease mortality with the introduction of specific vaccination programs.4 Deaths due to pertussis in infants too young to be vaccinated remain an important challenge.

The past fifteen years has seen the introduction of a number of major surveillance and vaccination initiatives in Australia:

a national disease notification system (NNDSS) in 1991;

the Australian Childhood Immunisation Register (ACIR) in 1996;5

the Seven Point Plan in 1997 (this included the Measles Control Campaign in the later part of 1998);6

the General Practice Immunisation Initiative in 1998;

implementation of new national notifiable diseases definitions, daily data updates to NNDSS and on-line data publication in 2004; and

Although specific enhanced evaluations are important, much can be learned from examining routinely collected data, especially for trends over time. This fourth report uses similar methods to the first three, bringing together data sources available at the national level relevant to VPDs and vaccination (deaths, notifications, hospitalisations and vaccination coverage) for all age groups. The diseases covered in this report include those for which vaccines were funded nationally for children during the review period (diphtheria, Haemophilus influenzae type b (Hib) disease, hepatitis B, invasive pneumococcal disease, measles, meningococcal C disease, mumps, pertussis, poliomyelitis, rubella, tetanus and varicella), those for which vaccines were available but only funded or recommended for specific risk groups (hepatitis A, influenza and Q fever) and for rotavirus, for which new vaccines became available in 2006. The report does not cover some other diseases which are at least partially preventable by vaccination, such as tuberculosis, on which reports can be found elsewhere.7–9

This and the previous three reports, all from the National Centre for Immunisation Research and Surveillance (NCIRS), provide evidence of the impact of changes in vaccination policy over the past fifteen years, as detailed in Appendix 4. These reports provide baselines against which further initiatives can be evaluated.

Table 2. Number of deaths from diseases commonly vaccinated against, by decade, Australia 1926 to 1995 and 1996 to 2004*

Period

Diphtheria

Pertussis

Tetanus

Poliomyelitis

Measles†

Population estimate
(yearly average)

1926–1935

4,073

2,808

879

430

1,102

6,600,000

1936–1945

2,791

1,693

655

618

822

7,200,000

1946–1955

624

429

625

1,013

495

8,600,000

1956–1965

44

58

280

123

210

11,000,000

1966–1975

11

22

82

2

146

13,750,000

1976–1985

2

14

31

2

62

14,900,000

1986–1995

2

9

21

0

32

17,300,000

1996–2004

0

17

6

0

0

19,200,000

Indicates decade in which community vaccination started for the disease.

* Sources: Feery B. One hundred years of vaccination. Public Health Bulletin 1997;8:61–63; Feery B. Impact of immunisation on disease patterns in Australia. Medical Journal of Australia 1981;2:172–176. Deaths recorded for 1966–1975 and 1996–2004 updated with data provided by AIHW Mortality Database.